Healthcare Provider Details

I. General information

NPI: 1306834395
Provider Name (Legal Business Name): KRISTEN S FAHRNER M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 03/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 CENTRAL PARK DR SUITE 207
STEAMBOAT SPRINGS CO
80487-8816
US

IV. Provider business mailing address

6500 29TH ST STE 106
GREELEY CO
80634-8386
US

V. Phone/Fax

Practice location:
  • Phone: 970-879-3200
  • Fax: 970-879-4608
Mailing address:
  • Phone: 970-584-1063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number46327
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: